A long-term care lottery

FRAIL, elderly people are falling foul of a postcode lottery as hard-nosed bureaucrats in some regions refuse to accept responsibility for long-term care fees.

Strategic Health Authorities (SHAs) were last year ordered to investigate how many elderly people were entitled to full funding of their long-term care. While some SHAs are paying compensation to at least a third of people who should have had their care paid for, the Department of Health says three authorities have not yet paid out in any cases.

They are Trent SHA, North-East London SHA and Norfolk, Suffolk and Cambridgeshire SHA. Together, they have investigated 686 cases.

The figures from the Department of Health raise serious questions about the objectivity of the health authorities who are deciding these cases.

Age Concern policy officer Pauline Thompson says: 'The Department of Health figures raise more questions than they answer. How are they applying the eligibility criteria and even if they are correct, do all the staff understand them and always apply them consistently?

Money Mail has been in the forefront of highlighting the plight of elderly people who are wrongly made to pay for their long-term care. The recent announcement by Health Minister Stephen Ladyman that £180m is being paid to compensate desperately ill people who should have had their nursing care funded by the NHS appeared a step forward.

It is 16 months since Health Service Ombudsman Ann Abraham lambasted health authorities for using unlawful and unclear criteria when judging whether elderly people should pay for their own care.

The law states that if 'your primary need is a health care need' then you should receive NHS funded care. In the meantime, 70,000 family homes are sold each year to pay for long-term care home fees.

Philip Spiers of the Nursing Homes Fees Agency, which gives advice on long-term care fees, says: 'We think the £180m earmarked for compensation so far is the thin edge of the wedge. Thousands of people are not aware they may be able to get their nursing care funded by the NHS.

'We received 100 calls on Monday alone asking for advice. And the other organisations helping the elderly have also been inundated.'

Other SHAs are moving painfully slowly. According to the department's figures, Surrey and Sussex SHA has completed only 15 investigations of which five will now be reimbursed for their nursing fees. But it is still looking at another 860.

In some areas, a large percentage were wrongly made to pay for their care. In South Yorkshire 42% of the 163 cases the SHA has looked at proved to be eligible for funding. While a third of cases are being recompensed in Bedfordshire and Hertfordshire SHA and South-East London SHA.

Dr Ladyman told Parliament last week that on average around 10% of the cases reviewed will be compensated amounting to just 770 people whose care will now be NHS funded. And nearly half of the 11,724 complaints with SHAs have yet to be examined.

He says: 'There is also a big issue with all the SHAs about how far they are trawling through old cases to identify those who have been wrongly judged ineligible for fully funded care.'

The figures don't always tally with SHAs' own reports. Thames Valley SHA's board meeting in January was told it had 1,570 cases to review but in the figures put before Parliament it gave just 383 cases. It told the January board meeting nine had been judged eligible for funding, but the figures given to Parliament covering the period to the end of March say just four were eligible.

Dr Ladyman told the Commons that his department will check whether cases outstanding at the end of March have been completed by the end of July. And he expects future reviews to be completed by SHAs in two months.

• HAVE you had your case or that of an elderly relative reviewed by your Strategic Health Authority? Let us know what stage your review has reached. We need to know which SHA is responsible. You can email us or write to Long-Term Care, Money Mail, Daily Mail, Derry Street, London W8 5TT. Please include a daytime phone number.